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Encephalitis, also known as Chamki fever has claimed a lot of lives in Bihar and hence the topic has become hotter today. A lot of people are now wondering what causes this fever and how to prevent it. Here is an account of the causes of Chamki fever, its symptoms, and prevention methods. The cases reported Encephalitis or Acute Encephalitis Syndrome (AES) or Chamki fever can be explained to an extent as the inflammatory condition in the brain. The most common targets of Chamki fever are children and young adults. Chamki fever is noted to cause a huge amount of mortality and morbidity. The recent outbreak of Chamki fever in Bihar has resulted in over a hundred deaths in the districts of Muzaffarpur and the surrounding districts. More than 200 children have been admitted in hospitals in the state of Bihar diagnosed with high fever and a number of severe viral infection symptoms. Earlier during a similar outbreak of chamki fever in 2014, as many as 700 deaths were reported. Investigations into the causes of chamki fever Few of the terms that describe chamki fever are Litchi Havoc, Killer Encephalitis, Chamki Bhukar, and Deadly Litchi Toxin. Mangal Pandey, the health minister of Bihar had set up a team of medical industry professionals to investigate into the causes of chamki fever. The list of causes identified by this team includes consuming lychee on an empty stomach, going to bed with an empty stomach, and humid conditions resulting in dehydration in addition to some others. The recent reports have confirmed that the highest number of mortality on account of chamki fever is noted in the age group of 1 to 10. The number of cases diagnosed with chamki fever has peaked in the months of April, May and June with the disease-focused mainly in the regions in and around Muzaffarpur in Bihar. The predominant cases of chamki fever are noted in the children who were undernourished and visited the litchi farms as observed by a report published in the National Health Portal of India. Do litchi fruits cause chamki fever? Two commissions set up by the government to investigate into the causes of chamki fever had concluded that malnourished children who consumed litchis and slept without food were affected with chamki fever in the pre-monsoon season in the early mornings. Their studies tried to establish a relationship between low blood glucose levels noticed in poor and malnourished children who slept with an empty stomach and a toxic chemical known as methylene cyclopropyl-glycine (MCPG) found in litchis that affects the brain during undernourished conditions. However, this theory has been discredited recently and the recent claims point out to the environmental factors like heat waves and the poor rainfall in these regions as the causes for chamki fever. During earlier outbreaks of chamki fever in 2005, 2011, 2013, and 2014, the temperature was more than 38 degrees and humidity was more than 50 percent. In Muzaffarpur, the sharp rise of humidity in nights make the condition worse for young children. Understanding Acute Encephalitis Syndrome (AES)? CDC describes acute encephalitis syndrome as a clinical condition predominantly caused due to infection by Japanese encephalitis virus (JEV) or due to some other infectious and non-infectious reasons. Symptoms of chamki fever (Encephalitis or Acute Encephalitis) The symptoms and signs of AES are an acute beginning of fever associated with headache. This will be accompanied by a range of clinical neurological symptoms like mental confusion, delirium, disorientation, and even coma. Who are at the highest risk of chamki fever? The chamki fever causing virus is very commonly present in the rural areas. Hence the children living in these regions are noted with the highest risk of chamki fever. The incidence of chamki fever was the highest among the children between 0 to 6 years with the other possible ager group targeted by this illness being 7 to 10 years. The most common targets of chamki fever are people with a weak immune system who already have HIV/AIDS, those that take immunity suppressing drugs and those that are undernourished. The spread of Encephalitis or Chamki fever While viruses are said to be the most common causes for chamki fever (AES) in India, some other sources like bacteria, fungus, spirochetes, parasites, some toxins and chemicals were also said to cause this condition. Severe kinds of leptospirosis and toxoplasmosis are also found to be causing AES. Scientists have a notion that the toxin known as methylene cyclopropyl-glycine (MCPG) present in litchi fruit could be related to the inflammation of the brain. AES and chamki fever Any brain disease or AES cannot be termed as chamki fever. AES can be of different types including brain inflammation due to virus known as encephalitis, swelling of the protective membranes of the spinal cord and brain known as meningitis, any brain disease that can alter the brain structure and function like encephalopathy, and many kinds of neurological complications or malarial infections like cerebral malaria. The two important theories connected to the causes of chamki fever include the heat wave stroke and the toxins found in the locally grown litchi fruits. However, the recent views state that the main causes of chamki fever is the lack of acclimatization in children, heat wave and poor rainfall. Treating Encephalitis or Chamki fever The subjects reporting encephalitis must be treated urgently. The treatment plan for chamki fever will include antiviral medication, and steroid injections besides many others in order to support the body and relieve the subjects of the symptoms. During recent days, the PHCs have been instructed to provide an intravenous glucose infusion during the attacks of chamki fever. The subjects are also given a lot of rest, fruits and anti-inflammatory medicines to relieve the headache and fever. Though there is no cure noted for this disease, there are safer and effective vaccines available today to prevent chamki fever. How to prevent chamki fever or encephalitis Vaccination is advised as the most dependable preventive measure for encephalitis. In addition, using repellants, wearing long-sleeved clothes, maintaining hygienic conditions, washing hands with soap and water after using the toilet and before taking meals can help prevent the encephalitis that is caused due to the virus.

Acute Encephalitis Syndrome (Chamki Fever) causes, symptoms and prevention

What Is Chamki Fever/Acute Encephalitis Syndrome Chamki fever or encephalitis is an inflammatory condition of the brain resulting in a variety of associated symptoms. Acute Encephalitis Syndrome (AES) causes an acute-onset of fever associated with headache and most commonly reported in children and young adults. This illness brings about an alarming rate of morbidity and mortality. The recent outbreak of chamki fever in Bihar resulted in over 100 deaths in Muzaffarpur and its adjoining regions in the state of Bihar, India. Most notably, the similar outbreak of chamki fever resulted in about 700 deaths in 2014. Predominantly, chamki fever affects children and young adults in the age group of 1 to 10. The name chamki bukhar means fever condition associated with a seizure. Reports say that chamki fever or AES has spread in over 12 districts of Bihar including Muzaffarpur, Vaishali and East Champaran with Muzaffarpur declared as the worst hit zone. What is Chamki Fever or Acute Encephalitis Syndrome Acute encephalitis syndrome (AES) or chamki fever is a highly serious public health problem in India. It manifests as an acute onset of fever and a seriously affected mental condition resulting in confusion, disorientation, delirium, or coma. The affected individual may experience seizures. Chamki fever can happen in any age and at any time of the year. Muzaffarpur, Bihar and adjoining areas in Bihar are litchi producing districts. This disease mostly spreads far and wide in the months between April and June especially in children who are undernourished with a history of consuming litchis from the neighboring orchards. Causes of Chamki fever or Acute Encephalitis Syndrome Viruses are said to be the main agents causing AES. However, other sources like bacteria, fungus, chemicals, parasites, spirochetes, toxins, and some noninfectious agents have also been noted to cause chamki fever as studied over the past few decades. Japanese encephalitis virus (JEV) is identified as the major cause of AES in India. The percentage of this agent ranges from 5-35 percent. Nipah virus and Zika virus are also said to be AES causing agents. In some cases. The other agents causing chamki fever include Influenza A virus, simplex virus, mumps, dengue, West Parvovirus B4, Nile virus, Epstein-Barr virus Chandipura virus, measles, enteroviruses, scrub typhus, and S pneumonia. Symptoms of chamki fever or Encephalitis Some of the prominent and most common symptoms of chamki fever include High temperature, Headache, extreme sensitivity to light, stiff neck and back, nausea, and mental confusion. In severe cases of chamki fever, seizures and paralysis can result. Japanese encephalitis virus (JEV) As discussed so far, JEV is identified as the major cause of AES in India. This virus is spread by mosquitos and it is a kind of flavivirus. This virus belongs to the same genus like dengue, yellow fever, and West Nile viruses. So far no cure has been discovered for chamki fever. The treatment available now focuses mainly on relieving the severe clinical symptoms found in the affected persons and supporting the patients to overcome the infective condition. Treatment for chamki fever or Encephalitis The affected persons must be treated immediately to avoid severe complications. The patients must be admitted to the Intensive Care unit or ICU to prevent any kinds of major mishaps. Chamki fever can be treated with anti-inflammatory drugs including Acetaminophen, Ibuprofen and Naproxen Sodium which can bring down the temperature and headache. Majority of cases reported with chamki fever can get resolved in a matter of a few days. However, some severe cases can take about a few weeks to recover.

What Is Acute Encephalitis Syndrome (Chamki Fever) - All you need to know

<ul><li>There have been 129 deaths due to the Acute <keyword id="6382102" type="UNKNOWN" weightage="20" keywordseo="encephalitis">Encephalitis</keyword> Syndrome (AES) in <keyword id="30033" type="LOCATION" weightage="20" keywordseo="Bihar">Bihar</keyword> so far. </li><li>The National Research Centre on Litchi has denied speculations linking litchi to causing the syndrome. </li><li>The state-run All India Institute of Medical Sciences (<keyword id="40458" type="COMPANY" weightage="20" keywordseo="AIIMS">AIIMS</keyword>), Delhi, will soon study the actual cause behind the AES syndrome, which is listed under 'unknown category'. </li></ul>129 children have died so far in the Indian state of Bihar due to the latest outbreak of the acute encephalitis syndrome (AES). While poverty and lack of access to healthcare failed the children and their families, a humble fruit, litchi or <keyword id="1168849" type="PERSON" weightage="20" keywordseo="lychee">lychee</keyword>, is taking the fall for the epidemic. The common ground between litchi and encephalitis is <keyword id="6374885" type="LOCATION" weightage="20" keywordseo="Muzaffarpur">Muzaffarpur</keyword>, the centre of the outbreak and the country’s biggest litchi producing district. “We have witnessed around 20% decline in litchi sales in last one week after AES connection with this fruit,” <a href="https://timesofindia.indiatimes.com/city/patna/bihar-aes-outbreak-brings-litchi-sales-down-by-15-20/articleshow/69935680.cms">KP Thakur, managing director of a litchi processing and exporting firm, told the Times of India</a>. The fall in demand occurred after the state government of Bihar issued an advisory for parents to not allow their children to eat the fruit. The advisory was based on a speculation that litchi may be the major cause for the encephalitis syndrome, that affects children under the age of 10. "The cases of AES might be linked to litchi but the disease can be caused by a whole plethora of infections and encephalopathy situations," Professor Sheffali Gulati, Chief of Child Neurology Division, Department of Paediatrics AIIMS <a href="https://www.livemint.com/news/india/aiims-delhi-to-find-out-cause-of-aes-listed-in-unknown-category-1561276211601.html">reportedly said</a>. The speculations regarding litchi being the cause for encephalitis gets validity from <a href="https://www.scmp.com/news/asia/south-asia/article/3014212/encephalitis-lychees-kills-31-children-india-say-health">a research done by the United States in 2005</a>, stating that a toxic substance in the fruit may be the reason. On the other hand, Vishal Nath, Director of National Research Centre on Litchi, has denied the charge that litchi has any link to the cause of the disease. Litchi is sold in many other countries but we don’t hear such epidemics elsewhere, he argued in an interview with IANS, adding that the fruit was a rich source of vitamin B, Calcium, Potassium, Sodium and phosphorus. From pride to panic in six months India exports a part of its litchi produce every year. The government of India wanted to promote the fruit earlier this year by giving it a ‘Geographical Indicator’ (GI) tag. “We have been waiting for GI tag for shahi litchi for a long time. The move has come as a boon for litchi cultivators of the region,” <a href="https://timesofindia.indiatimes.com/city/patna/muzaffarpur-shahi-litchi-gets-gi-tag/articleshow/66297801.cms">Nath had earlier said</a> adding that the GI tag will fetch them “good money.” <div type="javascript" title="Custom" contenttype="Video"><cdata><![CDATA[
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 Six months later, the same country is debating whether fruit is lethal for young children. The real reason The debate over the dangers of litchi may distract from the actual reason where the national anger must pour over -- poverty and lack of access to basic healthcare, which millions suffer from 70 years after independence. It’s not just the poor children of Muzaffarpur who ate the fruit, but the ones who died were mostly poor. The United Nations’ Global Hunger Report for 2018 placed India at 103rd spot out of 119 countries. The National Family Health Survey says almost half of the children under five in Muzaffarpur are stunted, almost 60% were anaemic, and more than 40% were underweight. A health ministry survey found that none of Muzaffarpur's 103 primary health centres - and its only community health centre - were even considered fit for evaluation, <a href="https://economictimes.indiatimes.com/news/politics-and-nation/poverty-not-lychees-the-real-culprit-in-indian-brain-fever-outbreak/malnourishment-is-the-underlying-cause/slideshow/69888516.cms">the Economic Times reported</a>. The state-run All India Institute of Medical Sciences (AIIMS), Delhi, will soon study <a href="https://www.livemint.com/news/india/aiims-delhi-to-find-out-cause-of-aes-listed-in-unknown-category-1561276211601.html">the actual cause behind the AES syndrome</a>, which is listed under 'unknown category'. The anxiety of the litchi farmers of Muzaffarpur will continue until the final results of the study are out.

India's tragic encephalitis epidemic has hit a humble fruit, Lychee, and its farmers

<ul><li>Encephalitis syndrome death toll crossed 100 in Muzaffarpur, Bihar, on Monday.</li><li>CM <keyword id="6358190" type="PERSON" weightage="20" keywordseo="Nitish-Kumar">Nitish Kumar</keyword> has called an emergency meeting with senior health officers.</li><li>₹400,000 Ex-gratia announced for the families.</li></ul> Bihar is witnessing an outbreak of Acute Encephalitis Syndrome (AES) as the death toll crossed 100 on Monday. Ten more children died due the syndrome on Monday in <keyword id="527716" type="PERSON" weightage="20" keywordseo="Muzaffarpur-district">Muzaffarpur district</keyword>’s Sri Krishna Medical College and Hospital (SKMCH) in Bihar, medical superintendent of the hospital, Sunil Shahi, <a href="https://www.indiatoday.in/mail-today/story/encephalitis-deaths-lapses-behind-bihar-brain-fever-horror-1550908-2019-06-18">informed</a> media on Monday. Bihar Chief Minister Nitish Kumar has called in an urgent internal meeting to take stock of the situation. Senior officers of the Health ministry are expected to attend the meeting. Earlier, on Saturday, Bihar Health Minister Mangal Pandey had said that the state government is doing its best to save the children, <a href="https://www.thequint.com/news/india/muzaffarpur-deaths-hypogylcemia-bihar-brain-fever-outbreak?utm_campaign=fullarticle&amp;utm_medium=referral&amp;utm_source=inshorts">reported ANI</a>. “Everything is being made available, from medicines to doctors. We have even called doctors and nurses from AIIMS in Patna,” Pandey said, adding that protocol is being adhered to while monitoring things, <a href="https://www.thequint.com/news/india/muzaffarpur-deaths-hypogylcemia-bihar-brain-fever-outbreak?utm_campaign=fullarticle&amp;utm_medium=referral&amp;utm_source=inshorts">as per The Quint</a>. The minister also said that six ambulances will be operational at the hospital from Friday and a new ward with 100-bed capacity will be made operational soon, after holding a meeting with SKMCH staff. CM Kumar expressed grief over the unfortunate deaths and announced an ex-gratia of ₹400 ,000 for the families who have lost their children. Encephalitis and Bihar Bihar has been affected by the disease before. In 2014, encephalitis, caused 379 deaths in Bihar. It was said to be due to the delay in implementation of centre’s ambitious project to curb the disease. The then Health Minister, Dr Harsha Vardhan had then visited SKMCH and announced a 100-bed super-speciality facility which is still incomplete. On Sunday, Vardhan said it will be operational in six months. A 10-bed facility for treatment of children also awaits completion. Encephalitis deaths in Muzaffarpur, and adjoining places such as, Sitamarthi, Motihari, Sheohar and Vaishali have been an annual feature for the last three decades. Another lapse in this prevailing problem was a weak awareness campaign by the government. Director-in-Chief, Disease Control, Bihar, RD Ranjan, after his visit to Muzaffarpur on Friday, 14 June, said, “We can confirm the data as of 10 June.” Till then, 34 deaths had taken place and 109 cases of brain fever were reported. He reiterated that none of the deaths, till then, have been caused by AES. “The casualties were result of hypoglycaemia,” Ranjan <a href="https://www.thequint.com/news/india/encephalitis-bihar-muzzaffarpur-brain-fever-outbreak">told Quint</a>.

CM Nitish Kumar to hold internal meeting as Encephalitis death toll crosses 100

<ul class="summary-list"><li>Though the <keyword id="1754604" type="PERSON" weightage="60" keywordseo="coronavirus">coronavirus</keyword> is primarily a respiratory disease that affects the lungs, it can affect the <a href="https://www.businessinsider.com/coronavirus-can-cause-heart-infections-2020-3">heart</a> and <a href="https://www.businessinsider.com/coronavirus-blood-clots-strokes-young-patients-2020-4">brain</a>.</li><li>A new study shows that some coronavirus patients experience <a href="https://www.businessinsider.com/coronavirus-causes-strokes-inflammation-in-blood-vessels-clots-2020-4">strokes</a>, swelling in the brain that's linked to delirium, and potentially fatal nervous system issues.</li><li>These neurological symptoms occured in patients with both mild and severe coronavirus cases.</li><li>Some researchers are concerned that the symptoms could manifest in recovered patients in the years to come, leading to an epidemic of "<keyword id="6450874" type="UNKNOWN" weightage="60" keywordseo="brain-damage">brain damage</keyword> linked to the pandemic."</li></ul>The coronavirus doesn't just target our lungs. A growing body of research shows that <keyword id="8763838" type="UNKNOWN" weightage="60" keywordseo="covid-19">COVID-19</keyword> is linked to potentially fatal brain damage and neurological problems. According to <a href="https://academic.oup.com/brain/article-lookup/doi/10.1093/brain/awaa240">a study</a> published Wednesday in the journal Brain, some coronavirus patients experience brain swelling that's accompanied by episodes of delirium. Other patients develop nervous-system disorders like Guillain-Barré syndrome that can cause paralysis, while a few have life-threatening strokes."We're seeing things in the way COVID-19 affects the brain that we haven't seen before with other viruses," Michael Zandi, one of the new study's co-authors, <a href="https://www.theguardian.com/world/2020/jul/08/warning-of-serious-brain-disorders-in-people-with-mild-covid-symptoms">told The Guardian</a>. The researchers found that the neurological symptoms weren't limited to patients with severe cases (those that require ventilation or supplementary oxygen)."You can have severe neurology, you can be quite sick, but actually have trivial lung disease," Zandi added.<h2>One patient thought a family member had been replaced by an imposter</h2>The study authors examined 43 coronavirus patients between the ages of 16 and 85. All were treated at the National Hospital for Neurology and Neurosurgery in London between April 9 and May 15.Ten of those patients had severe swelling in their brains that was accompanied by episodes of delirium. One, a 55-year-old woman without any prior psychiatric history, started acting oddly three days after being discharged from the hospital, according to her husband. She repeatedly took her coat on and off, then started having auditory and visual hallucinations, including saying she could see lions and monkeys in her home. Then the patient developed a Capgras delusion, a psychiatric disorder in which a person thinks a friend or family member has been replaced by an identical imposter.<div type="image" title="UK ambulance NHS coronavirus" height="827" width="1200" msid="76864237" hostid="261"></div>Another dozen patients observed in the study had swelling in their central nervous systems; one person within that group died. Nine of those 12 patients were diagnosed with acute disseminated encephalomyelitis (ADEM), a rare kind of inflammation that usually attacks nerves in children's brains and spinal cords after an infection like mumps or measles.The study authors reported that the number of ADEM cases at the hospital rose from one per month before the coronavirus pandemic to two or three per week in April and May. Seven other patients in the study were diagnosed with Guillain-Barré syndrome; some them developed neurological symptoms up to three weeks after their other <keyword id="8889783" type="UNKNOWN" weightage="60" keywordseo="Covid-19-symptoms">COVID-19 symptoms</keyword>.Overall, the researchers found that life-threatening neurological conditions weren't necessarily linked to severe respiratory symptoms among patients — that means a patient's lungs could be fine, but their brain may not be. <h2>Coronavirus-related strokes can happen regardless of a patient's age</h2>Eight patients in the study — including a 27-year-old woman with mild coronavirus symptoms — had strokes caused by blood clots in their brains. <a href="https://www.businessinsider.com/coronavirus-causes-strokes-inflammation-in-blood-vessels-clots-2020-4">Other recent research</a> also found that even young patients with mild COVID-19 cases could experience blood-clot-related complications <a href="https://www.businessinsider.com/coronavirus-blood-clots-strokes-young-patients-2020-4">like strokes</a>. In April, a group of doctors in New York City reported that five coronavirus patients in their 30s and 40s, most of whom had no past medical history, experienced life-threatening strokes and had to go to the hospital.<div type="image" title="New York coronavirus" height="1429" width="2000" msid="76864239" hostid="261"></div>Similarly, a study of 214 COVID-19 patients at three hospitals in Wuhan, China, found that 36% had neurological symptoms like impaired consciousness or cerebrovascular diseases, including strokes. That research is not yet <a href="https://www.medrxiv.org/content/10.1101/2020.02.22.20026500v1.full.pdf">peer-reviewed</a>, however.<h2>An epidemic of 'brain damage linked to the pandemic'</h2>The authors of the new study suggest that doctors should follow up with recovered coronavirus patients to "ascertain the long-term consequences of this pandemic."Zandi's team and other researchers are concerned that some brain-damage issues may not manifest for some time after patients have left the hospital. "My worry is that we have millions of people with COVID-19 now. And if in a year's time we have 10 million recovered people, and those people have cognitive deficits ... then that's going to affect their ability to work and their ability to go about activities of daily living," Adrian Owen, a neuroscientist who was not involved in the study, <a href="https://www.reuters.com/article/us-health-coronavirus-brains/scientists-warn-of-potential-wave-of-covid-linked-brain-damage-idUSKBN24837S">told Reuters</a>.<div type="image" title="human brain" height="1494" width="2200" msid="76864241" hostid="261"></div>This is similar to a phenomenon observed in the decades following the 1918 Spanish flu pandemic: Between 1917 and the 1930s, more than 1 million people were diagnosed with encephalitis lethargica, or <a href="https://theconversation.com/a-viral-infection-of-the-mind-the-curious-case-of-encephalitis-lethargica-660">"the sleepy sickness</a>." The disorder, caused by swelling in the brain, brought excessive sleepiness and severe neurodegeneration that left some patients disabled."It's a concern if some hidden epidemic could occur after COVID where you're going to see delayed effects on the brain, because there could be subtle effects on the brain and slowly things happen over the coming years, but it's far too early for us to judge now," Zandi <a href="https://www.theguardian.com/world/2020/jul/08/warning-of-serious-brain-disorders-in-people-with-mild-covid-symptoms">told The Guardian</a>.Still, he <a href="https://www.reuters.com/article/us-health-coronavirus-brains/scientists-warn-of-potential-wave-of-covid-linked-brain-damage-idUSKBN24837S"> told Reuters</a>, some scientists are worried that the coronavirus could bring about an epidemic of "brain damage linked to the pandemic."

The coronavirus may cause brain damage, even in patients with mild cases, a new study found

Pathankot, May 12 () The litchi growers in Punjab staring at huge losses as the farmers are yet to be approached by contractors for their orchards amid a prolonged countrywide lockdown.In the past, contractors - mostly from outside states, including Uttar Pradesh - used to visit Punjab to take litchi orchards on lease, besides reserving them by paying advances to farmers.Last year too, litchi growers had suffered huge losses in Punjab, as many videos surfaced on social media, linking the fruit to acute encephalitis syndrome (AES).At that time, farmers reeled under losses as the litchi's price fell very low.Arvind Kalra, owner of 85 acres of litchi orchard here, said that till today, only one person from Uttar Pradesh's Saharanpur has approached him on phone."Such a situation was once seen at the time of operation blue star when ripened fruits were not plucked. Without traders and commission agents, how can we sell our fruits which are perishable items. Lockdown situation brought the harsh situation for farmers like us," he said.He has litchi orchards in Himachal Pradesh too but he will not be able to go there due to the lockdown.In Punjab, mainly two varieties of litchi - Dehradun and Calcutta - is grown by nearly 1,100 farmers in few districts, including Pathankot, Gurdaspur, Hoshiarpur and Ropar, covering nearly 3,000 acres of lands.Around 48 trees are grown in one acres and each tree yields approximately 50 to 100 kg of litchi according to its age, experts said.Jatinder Singh, horticulture development officer, Pathankot, said that this year, there is a very high yield production but like last year, farmers are facing serious problem."The harvesting time of litchi is from June 10 to June 25 and in- between, things will be under control to some extent," he noted.Mostly Punjab's litchi is sold in main vegetables and fruit markets in Delhi and Mumbai, from where it is sent to other states and exported to countries, including UAE, he said."We will issue passes soon to outstation traders, middlemen and commission agents and labourers so that farmers don't face any suffering," Jatinder Singh said.With nearly 12,500 labourers registered to be moved for their native states from Pathankot alone where orchards of litchi have spread over 1,600 acres of land, shortage of workers is another problem for the farmers.Sukhdev Singh Randhawa of Batala said that he has 17 acres of litchi orchard in Pathankot's Madhopur."I am residing in Batala around 90 KM away from my orchards in Madhopur and irrigating litchi tree is very essential for bumper production, otherwise the yield gets damaged. Warden of my orchards mostly from Bihar have already registered to return back to their native village. In coming days, labour shortage will more be a problem, when harvesting time will be at its peak. VSD BAL

Punjab litchi growers facing  losses amid lockdown

<ul><li>Indians are hoping that the Narendra Modi-led government will take a step forward to advance the ‘promised’ healthcare facilities in India. </li><li>India’s spending on healthcare is below some of the low-income countries which spend 1.4% of their GDP on health. </li></ul>The government will unveil its annual budget for the 2019-20 fiscal year on July 5, 2019, and people are longing for improved healthcare. It is likely to allocate ₹59,039 crore in the financial year 2019-20, an increase of 11% from the current financial year, <a href="https://www.indiaspend.com/why-indias-public-health-facilities-may-suffer-despite-a-likely-rise-in-health-spending/">according</a> to India spend. The government has already allocated ₹52,800 crore (budget estimates) in the health sector of the country,<a href="https://dea.gov.in/sites/default/files/MTEF%20Statement%20%28english%29%202018.pdf"> according to the medium term expenditure projection statement</a> presented in the Parliament by the Ministry of Finance. Indians are hoping that the Narendra Modi-led government will take a step forward to advance the ‘promised’ healthcare facilities in India. The interim budget did not prominently focus on the government’s flagship scheme, National Health Mission as it received only a marginal increase of ₹1,600 crore against ₹1,400 crore in 2018-19. 
 
 
 
 
 
 












 Defense over health Over the years, the government has been spending five times more on defense than on healthcare in the country. India’s health allocation is ₹63,538 crore in 2019-20 against an investment of ₹282,733 crore in defense. The trend in budget allocation for both departments have been much similar in the budgets announced for the past two years, the wire <a href="https://thewire.in/health/indias-defence-budget-is-nearly-five-times-the-health-budget">reported. </a> Health emergency in India The current government promised to address roadblocks in the healthcare sector including a shortage in infrastructure, access to medical facilities and inexpensive treatments. However, the current status of healthcare in India portrays a completely different picture. Recently India’s poorest state, Bihar faced a medical crisis when <a href="https://www.bbc.com/news/world-asia-india-48741451">more than 150</a> children — mostly under the age of 10 and malnourished — died of an outbreak of Acute Encephalitis Syndrome (AES) in Muzaffarpur district. "Children are dying because of a lack of medicines and treatment,"Rabri Devi, Bihar’s opposition figure. According to Rural Health Statistics Bulletin 2017-18, the country is short of 32,900 sub-centres (catering to a population of 5,000), 6,430 primary health centres (PHCs, catering to 30,000 people) and 2,188 community health centres that are supposed to address the health needs of 80,000-120,000 people in rural areas, as on March 31, 2018. Infact, only 7% of the sub-centres, 12% of primary health centres and 13% of the CHCs are functioning, <a href="http://nhm.gov.in/nhm/nrhm/guidelines/indian-public-health-standards.html">Indian Public Health Standards</a> (IPHS). The situation is much worse in tribal areas as it is short of 5,935 sub-centres, 1,187 PHCs and 275 CHCs, said the RHS 2017-18. The population-doctor ratio in government hospitals is 25 times lower in India than the ratio recommended by the World Health Organisation. ₹3 : Daily expenses on healthcare India spends less than two per cent of its GDP on healthcare, making it one of the lowest investors in the sector globally. The World Health Organisation places India’s healthcare spends behind Iraq and Venezuela. The country suffers from a lack of infrastructure and is short of doctors, particularly in rural areas. India spent 1.02% of its gross domestic product (GDP) in 2015. This spending has remained the same for almost six years. India’s spending on healthcare is even below some of the low-income countries which spend 1.4% of their GDP on health,<a href="http://pib.nic.in/newsite/PrintRelease.aspx?relid=180053"> pointed out </a>National Health Profile. The negligence in public health spending forces even poorer patients to seek private healthcare. The country is the sixth biggest out-of-pocket (OOP) health spenders in 2014 amongst low middle-income group, <a href="https://archive.indiaspend.com/cover-story/indians-sixth-biggest-private-spenders-on-health-among-low-middle-income-nations-78476">reported </a>India Spend. The current pace of slow increase in the healthcare budget will make it difficult for India to achieve targets like reducing the maternal mortality rate to 100 in 2018-20 and infant mortality to 28 deaths per 1000 live births by 2019.

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